Possibilities and limits of minimal invasive lacrimal surgery

Emmerich, K.-H.; Ungerechts, R; Rüsenberg, H.-W.

doi:10.1076/0167-6830(200006)1921-pft067

Cited by 26 publications

(5 citation statements)

References 5 publications

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“…Regarding DE, three-port system with an external diameter of 1.1 mm and internal diameter of 0.7 to 0.9 mm can permit the additional simultaneous use of microdrills, laser probes, micropunches, and miniature balloons [ 6 ]. Microdrill dacryoplasty utilizes battery powered miniaturized motor drills of 0.3 mm diameter, which can be easily incorporated along with the DE [ 7 ]. Wang et al [ 8 ] also reported successful outcomes in 84.9% of their patients with nasolacrimal duct obstruction (NDO).…”

Section: Resultsmentioning

confidence: 99%

Clinical Implication of Dacryoendoscopy in the Patients with Tearing: A Systematic Review

Kim¹,

Park²,

Lew³

2023

Korean J Ophthalmol

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Purpose: A systematic review of the literature on diagnostic and therapeutic indications, techniques, and complications of dacryoendoscopy (DE) was performed. Methods: The authors performed a PubMed search of articles published in English on DE. Data was collected and classified according to the categories of the disease. And the clinical outcomes and limitations were particularly analyzed.Results: The lacrimal drainage system from the canaliculus to the inferior meatus could be examined based on the specific anatomical features by DE. The canalicular mucosa is smooth and brightly colored, the lacrimal sac shows covering mucosa with good vascularization and the nasolacrimal duct is lined with bright tubular mucosal folds. DE allows direct visualization of the detailed internal condition of the lacrimal disorders, to directly diagnose the site of obstruction with accuracy and address the causes and recanalize the lacrimal drainage system using assisted micro lacrimal surgical instruments in the tearing patients. Conclusions: Better visualization of the lacrimal canal with DE improves the understanding of physiology and precise identification of the obstructing lesions, both of which are the key to a comprehensive management for the tearing patients.

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Section: Resultsmentioning

confidence: 99%

Clinical Implication of Dacryoendoscopy in the Patients with Tearing: A Systematic Review

Kim¹,

Park²,

Lew³

2023

Korean J Ophthalmol

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“…ENDI operations are generally performed under local anesthesia and are one of the minimally invasive procedures for treating PANDO (Supplementary file, Video 1 ). As compared with DCR, ENDI has various advantages in terms of surgical time, facial surgical scars, bleeding, and downtime 3 , 4 , 11 , 17 , 18 , 23 , 24 , 34 , 38 . In addition, because of the minimal risk of bleeding, ENDI can also be performed in patients receiving systemic anticoagulation and antiplatelet therapy.…”

Section: Discussionmentioning

confidence: 99%

“…Meanwhile, with the development of the dacryoendoscope and advances in the fiber-optic system, recanalization procedures have steadily evolved. Lacrimal recanalization surgery includes endoscopic-guided trephination DCR, dacryorhinotomy, microdrill dacryoplasty, laser dacryoplasty, and anterograde balloon dacryoplasty 3 – 10 . Silicone tube intubation and anterograde balloon dacryoplasty are commonly used for treating partial obstruction or stenosis of the lacrimal duct 11 – 13 .…”

Section: Introductionmentioning

confidence: 99%

Comparison of the efficacies of 1.0 and 1.5 mm silicone tubes for the treatment of nasolacrimal duct obstruction

Nakamura

Kamao

Mitani

et al. 2022

Sci Rep

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This retrospective observational study analyzed the postoperative outcomes of bicanalicular intubation using different diameters of tube stents for treating postsaccal nasolacrimal duct obstruction. A total of 130 patients diagnosed with postsaccal obstruction who underwent endoscopic-assisted silicone tube intubation were included in the study. Patients intubated with a 1.5-mm large-diameter tube were designated as the LD group, and those with a 1.0-mm normal-diameter tube were designated as the ND group. The patency rates of the two groups at 1 year after tube removal were compared using the Kaplan–Meier curve and restricted mean survival time (RMST) method with τ = 365 days. Results demonstrated that the recurrence rate after tube removal was significantly lower in the LD group as compared with the ND group (p = 0.001). The patency rates at 1 year after removal in the LD and ND group were 85.7% (95% confidence interval [CI]: 75.4, 91.9) and 73.9% (95% CI: 61.7, 82.8), respectively. When comparing the patency rates by the RMST method at τ = 365 days, the RMST difference, RMST ratio, and RMTL ratio were higher in the LD group at p = 0.045, 0.052, and 0.046, respectively.

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“…In recent years, the advent of advanced endoscopy technologies allowed for a handful of minimally invasive operating techniques to emerge, posing alternative treatment options. Two of which in particular, namely laser-assisted dacryoplasty and microdrill dacryoplasty, have been shown to be viable first-step procedures in the treatment of short-segment membranous stenoses of the nasolacrimal duct [ 9 – 11 ]. Not only do these procedures take less time than external DCR, but also treated patients show shorter convalescence [ 12 – 14 ].…”

Section: Introductionmentioning

confidence: 99%

Transcanalicular laser dacryocystorhinostomy for acquired nasolacrimal duct obstruction: an audit of 104 patients

et al. 2018

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PurposeExternal dacryocystorhinostomy (DCR) is considered as the gold standard in the treatment of acquired nasolacrimal duct obstruction. However, many advances have been made towards the development of modern minimally invasive therapies. These new techniques were proven less harmful to the patients’ skin and medial palpebral structures with their palpebral-canalicular pump mechanism. Options include endonasal and transcanalicular procedures. Here, we report on our 2-year experience with the surgical technique, results and complications of transcanalicular laser-assisted DCR.MethodsThis is a retrospective study. A total of 104 patients with acquired nasolacrimal duct obstruction underwent transcanalicular laser-assisted DCR combined with bicanalicular silicon intubation. We then analyzed intra-/post-operative complications and subjective and objective success rates. The institutional ethics committee ruled that approval was not necessary. The trial was registered with the German Clinical Trials Register (DRKS00012879).ResultsTranscanalicular laser-assisted DCR in combination with bicanalicular silicon intubation could be performed surgically successfully in 101 patients (97%). In three cases (3%) using the superior canalicular approach, positioning of the laser instrument at the anteroinferior rim of the middle turbinate failed. Complications included thermal injury to the canaliculus (one), canalicular infection (two) and silicon tube prolapse (ten). Functional success (resolution of preoperative symptoms) was achieved in 80 cases (77%), functional failure occured in 24 cases with all patients reporting persisting epiphora, 15 reporting failure to irrigate the nasolacrimal duct and 15 requiring secondary external DCR.ConclusionsLaser-assisted DCR shows promising results with few complications. It seems well suited as a second-step procedure after failed recanalization and before external DCR.

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Possibilities and limits of minimal invasive lacrimal surgery

Cited by 26 publications

References 5 publications

Clinical Implication of Dacryoendoscopy in the Patients with Tearing: A Systematic Review

Clinical Implication of Dacryoendoscopy in the Patients with Tearing: A Systematic Review

Comparison of the efficacies of 1.0 and 1.5 mm silicone tubes for the treatment of nasolacrimal duct obstruction

Transcanalicular laser dacryocystorhinostomy for acquired nasolacrimal duct obstruction: an audit of 104 patients

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